What might be a reason why the nurse practitioner did not prescribe a nasal steroid?

What might be a reason why the nurse practitioner did not prescribe a nasal steroid?

A 20 years old student come to the campus health center. Over the past, several days, he has developed nasal congestion, sneezing, and itchy and watery eyes. He had been participating in a service project in which they were cleaning up abandoned homes. The student says, “I often get this way when I’M exposed to dust. I wore a mask, but there really was a huge amount of dust flying around.” The patient has a prescription for fexofenadine, which has been effective but has not be taking it lately. The nurse practitioner instructs the patient to star taking his fexofenadine and recommends the use of oxymetazoline for his nasal congestion.

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